Republic of the Philippines

West Visayas State University

La Paz, Iloilo City

CLEARANCE CERTIFICATE
To Whom It May Concern:
This is to certify that _________________________________ is hereby cleared
of all University properties and service requirements as of _______________________,
in connection with his/her application for _____________________________________.

Office

Type Name & Authorized Signatures

Date

A. Department / Unit
B. College
C. Registrar
D. Library
E. Central laboratory
F. Supply
G. HRMO
H. Finance
I. Multi-Purpose Cooperative
J. Medical Center
K. Vice President
L. President

I hereby certify that all University property, access to university resources and
services have been returned and settled prior to my last day of service.

_______________________________
Name & Signature of Employee
_________________
Date

(Please read guidelines at the back of this page)

General Guidelines

1. To protect the assets and ensure maximum utilization of University resources,

fiscal and property clearance is required periodically prior to employees
temporary or final separation from the service.
2. The department or unit is responsible for assuring all university property, including
sensitive equipment that has been issued to employee is returned upon
permanent or temporary separation of employees.
3. The issuing department/unit may recall the equipment/resources or demand from
an employee in the event that the same is urgently needed by the University.
4. The responsibility centers/department/unit shall formulate policies and guidelines
to include sanctions, penalties or fines to protect the assets of the University while
ensuring timely submission of academic, administrative and financial obligations.
5. The Human Resource Management Office shall determine which of the clearance
items/areas affect the departing employee. Any clearance item that does not
apply to the employee can be denoted as N/A and signed by the HRMO.
Type of Clearance
Academic year-end Clearance
Summer class clearance
Vacation leave with pay
Sick leave with pay
Vacation leave without pay
Sick leave without pay
Study leave/Sabbatical leave
Transfer, Resignation, Retirement

Deadline of
Submission
May 15
May 30
5 days before
5 days before
15 days before
15 days before

Required Signature
A,B,C,D,E,F,G,H
A,B,C,D,E
A,B,C,D,E,F,G,H
A,B,C,D,E,F,G,H
A,B,C,D,E,F,G,H,I
A,B,C,D,E,F,G,H,I
A,B,C,D,E,F,G,H
A,B,C,D,E,F,G,H,I,J,K,L

6. This process may also appropriate for those WVSU personnel going on an
extended leave of absence, especially if there is a reasonable expectation that
the employee will not return to work.
7. Faculty members including those holding administrative designations are required
to submit summer clearance at the end of academic year to ensure that library
and learning resources, academic requirements and fiscal accountabilities are
promptly returned and settled before the start of academic year. Faculty members
and other teaching staff who failed to submit summer clearance after May 15 of
the academic year shall be charged with appropriate fines to be deducted from
their salary effective June, without prejudice to filing administrative liabilities on
Rules of Discipline of the University Code, Administrative Manual and other Civil
Service Rules.

ADCO Resolution No.13 2007